Provider Demographics
NPI:1093885329
Name:MATTHEW THAYER
Entity Type:Organization
Organization Name:MATTHEW THAYER
Other - Org Name:BELL MEDICAL SUPPLY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:
Authorized Official - Last Name:THAYER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:616-826-6231
Mailing Address - Street 1:3305 REMEMBRANCE RD NW
Mailing Address - Street 2:
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49534-7729
Mailing Address - Country:US
Mailing Address - Phone:616-826-6231
Mailing Address - Fax:616-791-4060
Practice Address - Street 1:3305 REMEMBRANCE RD NW
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49534-7729
Practice Address - Country:US
Practice Address - Phone:616-826-6231
Practice Address - Fax:616-791-4060
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-08
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIF332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies